High Reliability Organizations (HROs) offer benchmarks for other organizations and systems whose missions are critical but operate in challenging high-risk environments. Successful HROs offer insights on operations, culture, performance, and evaluation that can be adapted to other organizations to improve the reliability of achieving objectives.
Early research on HROs attempted to understand how organizations such as aircraft carriers and the air traffic control system could continuously produce desired outcomes despite the high uncertainties of input conditions (environment) and the inherent interdependence of operations. Observing these unlikely success stories led to the distillation of 5 principles:
• A preoccupation with failure.
• Reluctance to simplify.
• Sensitivity to operations.
• Commitment to resilience.
• Deference to expertise.
Recently, managers in less fraught, but still complex, organizations and systems have begun to adapt these principles to deliver a similar high reliability in outcomes. Among others, good candidates for applying the lessons of HROs include the cash management system and healthcare organizations and systems.
The Joint Commission on healthcare accreditation is sponsoring work to develop a path for healthcare organizations of various sorts to move toward high reliability outcomes. A 2013 Joint Commission paper by Mark Chassin and Jerod Loeb titled “High Reliability Healthcare: Getting There from Here” summarizes a process to move toward the goal. An important point it emphasizes is that the improvement is continuous: HROs seek perfection, but never finally reach it.
Chassin and Loeb lay out stages healthcare organizations might follow on the journey toward becoming an HRO. Other types of organizations would have to adapt these to their own circumstances, but they do provide a template for moving forward.
High reliability organizations (HROs) operate within challenging conditions. Think of air traffic control, aircraft carriers, and nuclear power plants for clear examples of such conditions. Mistakes in these settings often have catastrophic consequences.
Yet they seldom fail.
HROs have the unique ability to deliver stunning reliability in complex environments. How do they do it? What makes an HRO? Our latest slideshow provides a glimpse inside. Read through it here:
One of the most fascinating things about High Reliability Organizations (HROs) is their paradoxical nature. Despite existing in potentially hostile conditions where factors not under their control can emerge at any moment, they achieve the capability to absorb the unexpected and continue operating successfully.
The High Reliability Organization (HRO) is an irresistible topic. How can any organization (like an aircraft carrier) or organized system (like American commercial aviation) operate in a totally threat-filled environment without frequent catastrophic failure? How can any organization realistically seek perfect reliability under conditions where the unexpected is routine?
Organization design experts have been working out the answers to these questions over the past 20 years. What has emerged from this research is a growing understanding about how an organization in a complex environment can become a resilient, adaptable HRO.
People working in HROs continuously seek ways to improve processes, and use every failure as an opportunity to install beneficial changes. They do not assume that just because something has worked well in the past that it will always continue to do so. The people and the system they are part of are open to change.
Early research focused on “heroic” organizations like the U.S. commercial aviation system. In 2015, there were about 24,000 commercial flights every day, operating through a network of 476 control towers and 14,000 controllers. Yet there were zero fatalities due to operations in commercial aviation that year.
Vivid outcomes like this helped to highlight how HROs operate to manage the unexpected. These same principles can be used in more ordinary organizations and systems to improve performance. A prime example is how healthcare organizations of different types are working diligently to adopt HRO principles.
This infographic, The Making of a High Reliability Organization, gives a fast summary of the characteristics of an HRO. Managers of every organization should be familiar with HROs to evaluate how they might adopt operational and cultural factors that lead to very high reliability to their own environments.
High Reliability Organizations (HROs) are anomalies. They exist in the kind of very complex, fast-evolving environments where you would expect chaos to prevail. But it doesn’t. HROs are able to cope successfully with unexpected conditions. That’s what makes these unusual organizations so attractive to researchers.
What can we learn from them?
Knowledge about HROs is rooted in what we call “heroic” organizations like aircraft carriers and air traffic control systems where a thousand things must go right every moment or someone dies. People like Karl Weick and Kathleen Sutcliffe, two of the most prominent scholars in the field, are beginning to stretch the concepts developed by evaluating HROs to apply to less heroic settings like banking, healthcare and manufacturing.
Weick and Sutcliffe use the phrase “mindful organizing,” which entails “sense-making, continuous organizing, and adaptive managing” to summarize the approach taken by HROs. They identify 5 principles that make up the body of mindful organizing found in successful HROs, and in organizations that aspire to that continuously high reliability.
1. Preoccupation with Failure
Systems in modern organizations are complicated, and they experience failures. HROs focus like a laser on failure; they give “continuous attention to anomalies that could be symptoms of larger problems.” The basic insight here is that big problems don’t emerge fully formed in an instant. They are almost always preceded by smaller problems or anomalies, or evidence that would point to the big problem if it were given proper attention.
What HROs do NOT do is assume that if a control in place succeeds in containing a failure, everything is right. They look deeper into an incident to find underlying causes. They also do not lump a failure with common elements to another into a class that all are alike. Evidence is gathered and evaluated.
2. Reluctance to Simplify
Complexity means that organizations have numerous potential sources of failure, and HROs do not apply generalized terms to describe them. It is a common and convenient response to a problem to name a general kind of cause and consider it a solution, e.g., ‘the bank has a state of the art alarm system’ so the failure of the alarm can be fixed by replacing it. What if the alarm’s failure is caused by something deeper, what specifically was the cause? In HROs, the occurrence of a failure is taken as an opportunity to dig deeply into the details of the system involved to find a real cause-you differentiate the details within those broad, convenient generalizations.
3. Sensitivity to Operations
Operations happen in real time, they include both discrete components and the system they compose. As such, operations generate outcomes that we can observe. The HRO continuously evaluates outcomes to determine if they are in fact serving the objectives of the organization. They do not assume that the continuous outcomes will be the same as planned, assumed, or hoped for.
Operations are what an organization does. In this sense, HROs treat them as hands-on experiences from which lessons about the organization can be taken to further improve function in real time.
4. Commitment to Resiliency
“The signature of the high reliability organization is not that it is error-free, but that errors don’t disable it.” HROs are essentially adaptable, learning organizations. They can experience a failure but continue operating under degraded conditions while marshalling resources to restore capacity.
To operate like this, HROs can recognize emerging anomalies despite prior beliefs, experiences, or plans. In large part, this requires both open-minded observation and a willingness to react appropriately even under unanticipated conditions.
5. Deference to Expertise
The fact that an HRO must be open-minded rather than judgmental leads to the idea that the culture of the HRO defers to expertise. The key point, however, is that the “expert” involved is the person with hands-on knowledge of the operation at the point of a failure, not the “expertise” conferred by hierarchical authority.
In the HRO, the expert has access to upward reporting, and there is no intimidation from authority to impede the communication. The openness required for the HRO to succeed depends on accurate information from every source.
Not every organization will adapt every HRO principle, at least in the short term. Many organizations can improve continuous operational reliability by adapting the pieces that fit. Over time, more and more of the organization can be improved this way, moving toward the “perfect reliability” objective of the HRO.